As colleges and universities weigh the pros and cons of mandating COVID-19 booster shots and changing campus guidelines because of the fast-moving omicron variant, one question they might consider is, ”What is the end game?”
Omicron’s spread is undeniable. It ripped through South Africa and became the dominant strain quickly in the UK. There are still many unknowns, though early reports suggest it may not be as severe as delta and that vaccines do provide significant protection. So is the shuttering of campuses and shifting modalities necessary each time a new variant emerges?
Dr. Robert Quigley is the Senior Vice President and Global Medical Director at International SOS, which provides global access to health leaders to companies around the world, and an expert on crisis management and infectious disease. He says institutions of higher education should be assessing the cost-benefit of making such decisions and doing so frequently.
“It’s a difficult time for colleges and these are difficult decisions, but I think we need to have a more holistic approach,” he says. “We have to look at the emotional health of students. What are the consequences of acquiring this new variant in a fully vaccinated individual? What we know from omicron is that there has been no evidence from any country—my fingers are on the pulse every day because that’s what I do for a living—that this has caused a resurgence of hospitalizations or major illnesses in the general population. Do we need to shut everything down just to stop the transmission of this new variant amongst this population? And if so, what is the end game?”
About 40 colleges and universities, including the University of Delaware and the University of Massachusetts-Amherst, have opted to make booster shots part of their vaccine requirements for January, although the Centers for Disease Control and Prevention has not made the leap to consider a third dose to be “fully vaccinated.” Still others are waiting to hear more from the CDC, and it may be that the agency recommends them simply based on the tremendous spread occurring, as Dr. Anthony Fauci has suggested. But is that the right call for largely healthy 17- to 24-year-olds who are vaccinated?
“We like to make decisions, mandates, policies and procedures based on evidence as we study any phenomenon,” Quigley says. “I can understand the promotion of boosters in people that are immunocompromised, who are transplant patients, those in the elderly age group with comorbid problems. But the rest of the scholastic community, most of whom are young and healthy, I haven’t seen the evidence to say everybody run and get your booster. If you haven’t had the three doses, you can’t get back on campus? I don’t know if I can go there.”
Planning for the long term
The Catch-22 for institutions as they plan next steps is apparent and some are taking a guarded approach, especially given the number of faculty and staff who might fall into those categories in some form. Both Harvard and Stanford University, for example, are pushing students into remote learning when they restart in January. But could overreaching on protocols have a negative effect on vulnerable students who have gotten used to face-to-face learning? “I don’t know whether [omicron] is a pivotal point or not, and I’m not sure that it should be,” Quigley says. “Universities and colleges need to ask, what is going to be our reality moving forward? Is the answer going to be reverting back to the lockdowns and the virtual classes, which I personally think are incredibly unhealthy for this cohort of people?”
From multiple studies, the toll brought on by isolation and fear has severely impacted the mental health of students, who are weary from the roller-coaster of decisions and social severance of the past 20 months. As colleges continually flip-flop or react to spinoffs of coronavirus each semester, is changing guidance truly necessary? Could they wait longer and assess the landscape or is pressure to add boosters and shutting down too great? Yale University stood on its guidance and kept in-person learning going despite a case of omicron on campus last week. But even it decided shortly thereafter to mandate boosters and push final exams remotely.
Should colleges have more long-term vision given that coronavirus overall isn’t going away?
“I can promise you, we will get through omicron,” Quigley says. “It’ll race through here, as delta has been doing. And there will be another variant. So at what point do we say as a scholastic community, enough already? We’ve done all the necessary mitigation that the scientists and the clinicians have recommended. We’re going to have to accept the fact that there will be some endemic diseases that are going to be spreading through campuses as there are every year, whether it’s influenza, meningitis or hepatitis.”
Colleges, he says, might want to handle this crisis like any other one and start being far more proactive and thinking long term. “What we’re promoting in the corporate arena is pandemic planning. It’s no different than crisis planning,” Quigley says. “Why don’t we take a step back and say, as an institution that takes care of a lot of young people, why don’t we have a pandemic plan that we don’t just have parked on some shelf in the dean’s office, but rather one that we are constantly updating and one that we do some dry runs on like we would any other crisis plan? Why are we reacting this way? Why aren’t we being proactive? This isn’t going away. So let’s plan for it.”
Quigley fears that decisions by some institutions are reactions to those made by prominent universities.
“What frequently happens, the bigger schools with the loudest voices will set the standard, but what it is based on? Is it based on true evidence? Or is it based on some leader in the specific school that’s decided to draw a line in the sand?” he says. “Schools have been somewhat reactive over the last two years—masks on, masks off. Virtual and non-virtual. In-person and not in person. They’re bouncing back and forth because authorities are a little wishy-washy themselves. The CDC can only do the best they can with the evidence that they’re provided. But everything is still so novel. There are a couple of fundamental lessons that we’ve learned. One of them is that the whole world isn’t going to get vaccinated and that means variants will be generated. We have to accept how are we going to live with this virus in our environment.”